Craven Nursing Home Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff discussed incidents in daily huddles and shared learning across the provider, promoting openness and improvement. Leaders fostered a no blame approach, and reflective learning formed part of meetings and supervision structures. Audits routinely generated actions, which staff completed and monitored to embed safer practice. Staff told us they felt supported to learn.

The registered manager and staff members worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Staff escalated concerns promptly, such as weight loss or swallowing difficulties, and worked effectively with GPs, speech and language therapists (SALT) and other professionals. People received support during transitions, including hospital appointments and periods of admission. Care plans included essential information to guide staff, and where changes occurred, the registered manager took steps to update records.

Staff worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.Staff understood safeguarding and felt confident to raise concerns. They told us they would escalate issues promptly and believed leaders acted quickly. People and relatives said they felt safe. The service worked with external professionals where safeguarding-related risks were identified, including around clinical needs, deteriorating health and mental capacity. Incident reporting processes ensured managers reviewed events and followed up with people and families.

The registered manager and staff worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff involved people and relatives in decisions about their care, including choices about daily living, activities, food, and personal preferences. Families told us they could raise concerns at any time and meetings helped them contribute to managing risk. Care plans contained risk assessments for areas such as oxygen.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The service’s environment was clean, tidy and free from odour, with well maintained décor and accessible communal areas. Bedrooms were clean, spacious and personalised. Dining rooms were well presented, with table settings and appropriate equipment. Some fire doors required remedial action which had been identified through fire risk assessments, and these were being addressed by the provider.

The registered manager made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. There were enough staff on duty, and people consistently told us staff responded quickly when they needed help. Staff were safely recruited and there was a stable staff team which ensured consistency. Staff felt supported by leaders and received supervision, competency checks and regular team meetings. Staff described positive teamwork, and people and relatives said staff appeared skilled and knowledgeable. Leaders ensured there was a "no blame culture" following an incident to ensure the focus was on learning and development.

The registered manager and the provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.Staff followed safe infection prevention and control practices. We observed good hand hygiene, appropriate use of personal protective equipment and effective cleaning routines. The environment was visibly clean throughout. Dining areas were hygienic, and food was served safely, including for people choosing to eat in their rooms. People and relatives told us they found the home very clean.

The registered manager made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. The electronic system provided clear audit trails and alerts for issues such as duplicate administration. Staff carried out manual checks to confirm stock levels and completed regular audits, which generated actions that staff addressed promptly. Administration was observed to be safe, respectful and in line with protocols. Covert medicines, oxygen therapy and self-‑administration all had individualised risk assessments, best interest decisions and close partnership working with pharmacy and GP supported reviews. Staff worked with local health partners to reduce unnecessary medication and have external audits of medication practices to ensure good practice is being followed.